Provider Demographics
NPI:1740211432
Name:GWINN, SHARON MARIE (PHD, OTR/L, ABDA)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:MARIE
Last Name:GWINN
Suffix:
Gender:F
Credentials:PHD, OTR/L, ABDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 MELLON ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-2129
Mailing Address - Country:US
Mailing Address - Phone:724-304-0030
Mailing Address - Fax:724-304-0035
Practice Address - Street 1:2501 LEECHBURG RD
Practice Address - Street 2:SUITE A
Practice Address - City:LOWER BURRELL
Practice Address - State:PA
Practice Address - Zip Code:15068-3060
Practice Address - Country:US
Practice Address - Phone:724-304-0030
Practice Address - Fax:724-304-0035
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC003428L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2195109OtherFIRST HEALTH PROVIDER NUM
PA3446732OtherAETNA HMO PROVIDER NUMBER
PA01946729Medicaid
PA5121792OtherAETNA PPO PROVIDER NUMBER
PA1585451OtherHIGHMARK BC/BS PROVIDER N
PA237320OtherHEALTH AMERICA PROVIDER N
PA2195109OtherFIRST HEALTH PROVIDER NUM